How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | None | $67.61 | $67.61 | $79.43 |
BCBS Minnesota Setting Facility Modifier None Typical Low $72.44 Median $79.43 Typical High $123.03 | Facility | None | $72.44 | $79.43 | $123.03 |
BCBS Minnesota Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $81.28 | Professional | None | $64.57 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $269.15 Typical High $691.83 | Facility | None | $51.29 | $269.15 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $117.49 | Professional | None | $93.33 | $97.72 | $117.49 |
Health Partners Setting Facility Modifier None Typical Low $173.78 Median $275.42 Typical High $645.65 | Facility | None | $173.78 | $275.42 | $645.65 |
Health Partners Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $79.43 Typical High $426.58 | Facility | None | $39.81 | $79.43 | $426.58 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $60.26 Typical High $741.31 | Professional | None | $31.62 | $60.26 | $741.31 |
United Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $109.65 | Facility | None | $53.70 | $64.57 | $109.65 |
United Setting Professional Modifier None Typical Low $26.30 Median $45.71 Typical High $81.28 | Professional | None | $26.30 | $45.71 | $81.28 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where Minnesota sits
The same service costs 4.9 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Minnesota· 9th of 51
$79.43
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.